Social alienation and related factors in patients with neuromyelitis optica spectrum disorder: a cross-sectional study.

BACKGROUND

Neuromyelitis optica spectrum disorder (NMOSD) is a rare disabling autoimmune condition causing severe psychosocial impairment. Social alienation (SA), emotional detachment and behavioral withdrawal from social interactions, predicts adverse outcomes but lacks quantification in NMOSD.

AIMS: To investigate the status of SA and identify its influencing factors in Chinese NMOSD patients to guide clinical interventions.

METHODS

A cross-sectional study was conducted among 216 NMOSD patients recruited via WeChat groups from July 10 to 30, 2025. Participants completed validated questionnaires assessing sociodemographic characteristics, disease-related variables, and SA, alongside psychological (Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale) and functional outcomes (Barthel Index, SF-36). Multiple linear regression analysis was performed to identify predictors of SA.

RESULTS

The total GAS (General Alienation Scale) score of patients with NMOSD was 35.98 ± 7.23, which was in the moderate-to-high level. Depression (r = 0.542, p < 0.001), anxiety (r = 0.613, p < 0.001), sleep quality (r = 0.356, p < 0.001) were significantly positively correlated with social alienation, and basic activities of daily living (BADL) (r = -0.496, p < 0.001), health-related quality of life (HRQOL) (r = -0.452, p < 0.001), psychological resilience (r = -0.507, p < 0.001) were significantly negatively correlated with social alienation. Multiple linear regression analysis showed that perceived social support (β = -0.197, p = 0.002), psychological resilience (β = -0.187, p = 0.004), and depression (β = 0.288, p = 0.004) were influencing factors of GAS scores in NMOSD patients, explaining 47.2 % of the total variance.

CONCLUSION

NMOSD patients experience social alienation are associated with psychological distress, functional impairment, and insufficient social support. Interventions targeting depression management, resilience enhancement, and multidisciplinary social support networks are urgently needed to mitigate SA and improve long-term outcomes.